Finding an LMC you like
For pregnant mums, a good relationship with your LMC – that’s shorthand for “lead maternity caregiver” – is vital. Here’s how to choose an LMC you connect with.
Pregnancy is a journey, and your LMC is your trusted guide. But choosing a midwife or obstetrician isn’t simply a matter of trial and error. A national midwife shortage means that midwives are in hot demand and can book up early, and with obstetricians, if you are paying to engage their services, you have a vested interest in ensuring you are confident of their care. So it’s important that you find an LMC you feel understands and supports you, and one whose philosophy and practice resonates with your personal beliefs around childbirth. Here are five important qualities you should look for in an LMC.
What kind of communication do you need? Do you like a lot of details and information, or do you prefer to be told only what you really need to know? Be upfront with your LMC about the kind of communication you prefer, and find out whether he or she is able to provide what you need. Midwives are very busy, so it’s not always possible (nor desirable) to be able to text them at every hour of the day or night – but you should have a clear understanding of when you can expect to hear from her, when you should get in touch with her, and what to do if she can’t be reached. With obstetricians, you may not have a “direct line” to them in order to ask quick questions or raise immediate concerns, so be certain you understand what the protocol in with regard to communicating – do they have a nurse you can ring to ask questions of? What do you do when the office is closed but you’re concerned about something?
Feeling safe is one of the most important aspects of birth, and it’s your LMC’s job to facilitate a safe environment for you to relax and be comfortable in. Part of ensuring your safety is also requiring you to attend regular check-ups, making recommendations about testing you may wish to consider, and referring you to specialists if complications arise. An LMC who takes safety seriously is important, as you can be certain he or she has your and your baby’s best interests at heart.
Pregnancy is a time of immense change, and even if you have already had a baby before, best practices and standards can change a lot, even in just a few years. As research uncovers new information about what is safest and best for you and your baby, you want an LMC who is up-to-date on what’s happening in their field and can translate that into giving you the best care possible. Your LMC is a great source of information about pregnancy, labour, and birth, and you should feel comfortable asking questions and getting the answers you need. You should never feel rushed or dismissed.
Ideally, you want to see the same LMC throughout your pregnancy, labour, birth, and in the postnatal period. Your midwife should have a back-up, whom you should meet in case your midwife is unavailable for some reason. Find out about continuity of care – is she planning a holiday near your due date? What happens if your labour is long and she needs to leave to get some sleep? What if she has another mum in labour at the same time? With an obstetrician, you may get the luck of the draw depending on who is rostered on when you go into labour – unless you’re having a planned Caesarean, when you should know in advance who will be in attendance. Again, ensure you are familiar with the other doctors at your obstetrician’s practice, so you know who might be delivering your baby if he or she isn’t available.
Finally, it’s important that you feel respected, and that your cultural beliefs are honoured and integrated into your care. Your beliefs around testing and interventions should be taken into account. Talking with your LMC should be a two-way conversation – your LMC shouldn’t be telling you how it is going to be, but listening to what you want and being open and honest with you about what is safe, possible, and practicable. If you are having a Caesarean, you may have less options, but you should still have a say in things like skin-to-skin contact, your partner cutting the cord, lowering the drapes when your baby is born, etc. Birth is a unique experience and every labour and birth is different, so you want an LMC who respects your individuality.
Printed with permission from Pregnancy BUMP&baby magazine (bumpandbaby.co.nz)